Although communicable diseases still represent the major disease burden in Africa, preliminary data based on just ~1% of the continent's population, suggests that cancer incidence is increasing rapidly - faster than in the developed world - and that rates for specific types of cancers vary widely across Africa. In order to identif specific areas of focus for cancer control and prevention efforts, there is a dire need for high-quality cancer surveillance data, the kind that come from regional and national population-based cancer registries. To address this need in the West African country of Ghana, we propose here, as a first step, a hospital-based cancer registry based at the Korle-Bu Teaching Hospital, the largest hospital in Accra, the capital and largest city in Ghana, to develop effective procedures and training for hospital-wide case-finding/reporting covering the period 2009-2015 (Aim 1). We will develop procedures to link the cancer registry with existing tumor archives to create a registry-linked tumor bank and expedite assessment of pathology review and retrieval of pathology materials for molecular studies (Aim 2). Finally, we will survey other hospitals in Accra to assess the feasibility of future expansion to a population based cancer registry for all of Accr (Aim 3). Successful completion of our Aims will pave the way for a future population-based registry in Accra that will generate high-quality surveillance data to aid the effort of cancer control and prevention in Ghana. The Ghana registry data can also be used to compare with cancer patterns on African Americans to identify why persons of African descent are disproportionally affected by specific types of cancers, such as that of the prostate, renal cell carcinoma, and multiple myeloma.